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HomeMy WebLinkAboutComprehensive Community Service Committee - Agenda - 7/9/2024Hand-Outs for July 9th, 2024 Bayfield County CCS and Regional CCS Coordination Committee Meetings: 1. Meeting Agenda 2. Approved Minutes from April 9th, 2024 Bayfield County CCS Coordination Committee Meeting 3. Approved Minutes from April 9th, 2024 Regional CCS Coordination Committee Meeting 4. BCCS Response to Plan & Policy Recommendations – proposed April, 2024 5. Tamarack Health Presentation Handout on ER & BHU process / services 6. Bayfield County CCS Quality Assurance Report 7. Outcome Evaluation Plan 8. Program Evaluation Report 9. Updated CCS Marketing Materials - Brochure and Flyer Terry Barningham, Director Joint Meeting of Ashland County and Bayfield County Local Comprehensive Community Services (CCS) Coordination Committees And Ashland County and Bayfield County Regional Comprehensive Community Services Coordination Committee July 9th, 2024 at 12:30 p.m. An in person and remote meeting will originate from the Oredock Room at Ashland County Health & Human Services, 630 Sanborn Ave, Ashland, Wisconsin. Remote participation is available via Zoom with the link sent you via email, link below or by phone 715-312-626-6799 US (Chicago) https://us06web.zoom.us/j/86246221955?pwd=mIBw9FYWaabFhyqgybbdaPk9VQ22lb.1 Meeting ID: 862 4622 1955 Passcode: 697069 Ashland CCS Committee: Thomas Mittelstaedt Vacant Vacant Terry Barningham Pam Stanny Jan Kupczyk Bad River Tribal Representative Bayfield CCS Committee: Tom Croteau Johanna Perkins Vacant Thomas Mittelstaedt Sandra Notzke Jamie Vernon Regional CCS Committee: Ashland County: Terry Barningham, Pam Stanny, Jan Kupczyk, Vacant, Vacant, Bad River Tribal Representative Bayfield County: Tom Croteau, Johanna Perkins, Vacant, Sandra Notzke, Jamie Vernon Members-At-Large: Teri Ovaska, Thomas Mittelstaedt Bayfield CCS: Notice is hereby given, in the event the standing committee does not have a quorum, the County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter 3, section 2-3-1 (c)) Any person wishing to attend whom, because of a disability, requires special accommodations, should contact the Department of Human Services at 715-373-6144 at least 24 hours before the scheduled meeting time, so appropriate arrangement cans be made. ASHLAND COUNTY HEALTH & HUMAN SERVICES DEPARTMENT 630 Sanborn Avenue ● Ashland, WI 54806 ● (715) 682-7004 Fax: (715) 682-7924 ● E-mail: achsd@co.ashland.wi.us Agenda 1. Call to Order 2. Roll Call 3. Agenda for Ashland CCS only: A. Discussion and Possible Action: Review and Approval of the April 9, 2024 Meeting Minutes B. Discussion and Possible Action: Ashland Comprehensive Community Services Plan & Policy Updates 4. Agenda for Bayfield CCS only: A. Discussion and Possible Action: Review and Approval of the April 9, 2024 Meeting Minutes B. Discussion and Possible Action: Bayfield Comprehensive Community Services Plan & Policy Updates 5. Agenda for Regional CCS only: A. Discussion and Possible Action: Review and Approval of the April 9, 2024 Meeting Minutes 6. Presentation: Tom Jensen and Aimee Granger, process for ER visits to BHU stays and services and support 7. 2024 Annual Program Report 8. Update to the Outcome Evaluation Plan 9. Review Program Report 10. Children’s Services 11. Discussion and Possible Action: New Business 12. Opportunity for Public Comment (Limit 3 minutes please) 13. Other (Informational Items) a. Updates to brochure and flyer- Julie Winter, Quality Assurance and Improvement Coordinator 14. Future Meeting Dates (all meeting times 12:30 to 2):  Oct 8, 2024  Jan 14, 2025 C: Ashland County Board Chair, Gary Mertig Ashland County Administrator, Dan Grady Ashland County Clerk, Heather Schutte Bad River Tribal Chairman, Robert Blanchard Bayfield County DHS, Nina Bucher Bayfield County DHS, Sarah Traaholt Bayfield County Clerk, Lynn Divine Bayfield County Administrator, Mark Abeles-Allison Bayfield County Board of Supervisors Chair, Dennis Pocernich Red Cliff Tribal Chair, Nicole Boyd WI DHS Area Administration, Karlie Pierson WI Family Ties, Amy Polsin, Jessica Bigboy Ashland Daily Press Ashland and Bayfield County Regional Comprehensive Community Services (CCS) Coordination Committee Meeting Bayfield County Conference Room A Hybrid Meeting April 09, 2024 BCCS Members Present: Thomas Mittelstaedt, Tom Croteau, Cecelia Webb, Sandra Notzke, Jamie Vernon Members Excused: Johanna Perkins Others Present: Sarah Traaholt, De Ana Nelson*, Elizabeth Skulan, Jessica Bigboy*, Billie Keelin, Terry Barningham*, Pam Stanny, Jan Kupczyk, Val Levno *Attended virtually Call to order and Introductions Mittelstaedt called the meeting to order at 12:30 p.m. Roll Call Levno conducted roll call and noted that Ashland County, Bayfield County and Regional CCS Committee all have a quorum present. Levno introduced, Jamie Vernon, Red Cliff Representative for Bayfield County to the group. Levno also introduced Teri Ovaska to the group. Ovaska was hired as Levno’s successor as CCS Administrator. Discussion and Possible Action: Review and Approval of the January 09, 2024, meeting minutes. Discussion and Possible Action: Bayfield Comprehensive Community Services Plan & Policy update. Mittlestaedt and Notzke noted that their contact information needs to be updated. Discussion and Possible Action: Election of Chairperson. It was announced the Ceceila Webb is moving out of the area and has provided notice she will no longer be able to serve on the Bayfield County or regional CCS committees. Mittlestaedt recognized Ceceila Webb’s contribution to the CCS Committees. The Committee showed appreciation to Webb for her dedication and wished her well in future endeavors. Draft: Subject to change at the next CCS Coordination Committee Meeting Motion by Croteau, second by Notzke, to elect Thomas Mittlestaedt as Bayfield County Comprehensive Community Chairperson. Motion passed. Motion by Notzke, second by Webb, to approve Bayfield Comprehensive Community Services Plan & Policy with the updates on addresses and phone numbers as needed. Motion passed. Motion by Notzke, second by Croteau, to approve Bayfield Comprehensive Community Services Plan & Policy update. Motion passed. Presentation: Providing Psychotherapy, in-home, in-office, telehealth, and equine therapy in CCS – De Ana Nelson, Beautifully Broken Refuge Ranch Levno introduced De Anna Nelson, owner of Beautifully Broken Refuge Ranch to the group. Nelson is a licensed professional counselor that provides an array of services for the CCS program including equine therapy, art therapy, psychotherapy, in-home, in-office and telehealth services. Beautifully Broken Refuge Ranch provides a unique aspect to therapy because it is on a farm setting where nature and animals are used as healing agents. Nelson noted the name Beautifully Broken was derived from there being beauty in brokenness. Nelson wants to use her talents to help heal others. Nelson believes that a therapeutic bond between a participant and therapist is essential to creating a safe place for healing to begin. Nelson noted she also provides group services and enjoys providing care in a group setting. Groups help participants develop friendships and facilitate healing when individuals are working together. Nelson visits Bayfield and Drummond schools each one day a week for therapy. She hopes to incorporate the Washburn School District into the schedule soon. Nelson is impressed by CCS and its value to the community around participants. Service Facilitators provide participants with a team of needed support and services. CCS Program Response to Committee Recommendations of Plan & Policy Updates Levno reviewed a letter to the committee accepting their Plan & Policy update recommendations from the January 2024 meeting. Review Program Report Levno noted that the Ashland County referrals have been increasing. Ovaska stated this is not unusual after a holiday. Bayfield County referrals continue to steadily grow. Stanny questioned where CCS referrals come from. Ovaska noted that for Ashland County at least 50% of the referrals are made by the Tamarack Behavioral Health Unit. Levno noted referrals also come from Wellness and Recovery Courts, the Bad River Tribe, and through self-referrals. Croteau stated that just over 50% of referrals for Bayfield County come from other Bayfield County Department of Human Service units or programs including Aging and Disability, Economic Support, Youth Justice, Child Protective Services, Childrens Long-Term Services, and other Family Service programs. Croteau noted many referrals for Bayfield County also come from Tamarack Behavioral Health Unit. Croteau stated the number of children in the program continues to grow. There are currently fourteen youth in the program. Croteau noted providing services to children is more time-consuming and is more difficult during the school year. He reported that it is helpful to have additional vendor support to relieve some of the pressure off service facilitators to provide services after hours. Levno noted there are a few staffing changes. Levno is retiring on May 3, 2024. Ovaska was promoted internally to the position of the new CCS Administrator. Restructuring was necessary when Ashland County was unable to recruit needed licensed, Masters-level staff to fill Ovaska’s position of Service Director of ACCS and BCCS. Tom Croteau is taking over as BCCS Service Director. Job responsibilities of CCS Administrator and ACCS Service Director that do not need a licensed, Masters-level staff were combined to create the position of Quality Assurance and Improvement Coordinator – Ashland/Bayfield CCS. The person hired for this new position will be starting April 22nd, 2024. Bayfield is currently recruiting for a master’s level mental health professional. Levno reported CCS provider, Christian Servants Home Care, had been able to recruit and retain staff in a way that other contracted providers have not been able to dur to their unique business model. Levno noted that Visa Care continues to have trouble hiring staff. Levno reported she excited about Vista Care’s STAR Program. Using this model, Vista Care’s staff “have a minimum of a bachelor’s degree, are familiar with risk assessment and mitigation, and are supervised by fully licensed clinicians. Treatment includes trauma, interpersonal conflict, mood disorders, and grief/loss.” Levno reported the Ashland County Board has requested the Ashland County CCS team provide more outreach to the homeless. Ovaska noted staff have been present at Pearson Plaza the past few Thursdays trying to speak with homeless individuals who are present. Staff can help individuals place phone calls, provide local resources, and offer referrals to the CCS program when there is interest, and a referral is appropriate. The Brick is partnering with Ashland County to assist in providing outreach. CCS will report the impact of their outreach to the Ashland County Board at a future meeting. Children Services Ovaska provided a handout listing the services available to children in the CCS program. The handout provides an overview to parents, guardians, and participants new to the program. Kupczyk asked if local transportation needs were being met. Levno noted that for medical appointments CCS participants must use MTM (formerly Veyo). Ovaska noted that BART is a good local transportation resource. Croteau agreed BART is very accommodating. Levno and Croteau continue to conduct monthly discussions with the WI DHS and MTM so local issues with the non-emergency medical transportation provide by MTM are addressed. Stanny asked if there were still volunteer drivers to provide transportation. Croteau noted that Bayfield County has veteran volunteer services. Skulan stated that Aging and Disability also has a volunteer driver program for the elderly and disabled. However post-COVID, the pool is smaller. Levno noted that Ashland Aging and Disability has something similar. However, individuals who are eligible for transportation must use MTM when traveling to medical appointments. Discussion and Possible Action: New Business Levno asked the group about topics of interest for presentations at future meetings. Stanny requested a presentation regarding behavioral health inpatient availability and the impacts locally. Croteau noted it is a timely topic given the reduced inpatient availability with the renovations that are occurring at Tamarack Behavioral Health Unit. Croteau suggested Tom Jensen from Tamarack as a potential speaker on this topic. Levno noted that additional suggestions can be sent to Levno (through May 3, 2024), Ovaska, Croteau, or Service Facilitators. Kupczyk questioned if she or anyone else should act if they are aware of service providers who are out in public and they are not working (e.g., on their phones, etc.) when they should be providing services. Levno noted that she has personally reported this. Levno encouraged “if you see something, say something”. Levno also noted that CCS participants or their parents or guardians generally voice their concerns to staff members if a service or provider is not working when with the participant. Levno also noted that if there are multiple complaints, CCS will discontinue authorizing services with the provider. Croteau recognized Levno for her many years of service to the county, committee, and region. Levno thanked the group for their dedication to the committee. Mittelstaedt also thanked Webb for her service on the committee. Opportunity for Public Comment Bigboy stated she appreciated being able to join the meeting today. Informational Items (other) Mittelstaedt thanked the staff for making meetings available virtually as well as in person. Future Meeting Dates July 9, 2024 – Ashland County 12:30 p.m. October 8, 2024 – Bayfield County 12:30 p.m. The meeting was adjourned at 1:28 p.m. Respectfully submitted, Sarah Traaholt, Bayfield County Clerk III Ashland and Bayfield County Regional Comprehensive Community Services (CCS) Coordination Committee Meeting Bayfield County Conference Room A Hybrid Meeting April 09, 2024 Regional CCS Committee: Ashland County – Terry Barningham*, Pam Stanny, Jan Kupczyk, Billie Keelin Bayfield County – Tom Croteau, Cecelia Webb*, Sandra Notzke, Jamie Vernon Members-at-Large Present: Val Levno, Thomas Mittelstaedt Members Excused: Erica Toman, Johanna Perkins Others Present: Sarah Traaholt, De Ana Nelson*, Elizabeth Skulan, Jessica Bigboy* *Attended virtually Call to order and Introductions Mittelstaedt called the meeting to order at 12:30 p.m. Roll Call Levno conducted roll call and noted that Ashland County, Bayfield County and Regional CCS Committee all have a quorum present. Levno introduced, Jamie Vernon, Red Cliff Representative for Bayfield County to the group. Levno also introduced Teri Ovaska to the group. Ovaska was hired as Levno’s successor as CCS Administrator. Ashland County: Discussion and Possible Action: Review and Approval of the January 09, 2024, meeting minutes. Discussion and Possible Action: Ashland Comprehensive Community Services Plan & Policy update. Levno reviewed changes and updates with the group. Mittelstaedt noted that his information needs to be updated. Bayfield County: Discussion and Possible Action: Review and Approval of the January 09, 2024, meeting minutes. Draft: Subject to change at the next CCS Coordination Committee Meeting Motion by Kupczyk, second by Keelin, to approve the Ashland County CCS January 09, 2024, meeting minutes as presented. Motion passed. Motion by Kupczyk, second by Stanny, to approve Ashland Comprehensive Community Services Plan & Policy update with updates on addresses and phone numbers as needed. Motion passed. Motion by Notzke, second by Croteau, to approve Bayfield Comprehensive Community Services Plan & Policy update. Motion passed. Discussion and Possible Action: Bayfield Comprehensive Community Services Plan & Policy update. Mittlestaedt and Notzke noted that their contact information needs to be updated. Discussion and Possible Action: Election of Chairperson. It was announced the Ceceila Webb is moving out of the area and has provided notice and will no longer be able to serve on the Bayfield County or regional CCS committees. Mittlestaedt recognized Ceceila Webb’s contribution to the CCS Committees. The Committee showed appreciation to Webb for her dedication and wished her well in future endeavors. Regional Committee: Discussion and Possible Action: Review and Approval of the January 09, 2024, meeting minutes. Presentation: Providing Psychotherapy, in-home, in-office, telehealth, and equine therapy in CCS – De Ana Nelson, Beautifully Broken Refuge Ranch Levno introduced De Anna Nelson, owner of Beautifully Broken Refuge Ranch to the group. Nelson is a licensed professional counselor that provides an array of services for the CCS program including equine therapy, art therapy, psychotherapy, in-home, in-office and telehealth services. Beautifully Broken Refuge Ranch provides a unique aspect to therapy because it is on a farm setting where nature and animals are used as healing agents. Nelson noted the name Beautifully Broken was derived from there being beauty in brokenness. Nelson wants to use her talents to help heal others. Nelson believes that a therapeutic bond between a participant and therapist is essential to creating a safe place for healing to begin. Nelson noted she also provides group services and enjoys providing care in a group setting. Groups can help participants develop friendships and facilitate healing when individuals are working together. Nelson visits Bayfield and Drummond schools each one day a week for therapy. She hopes to incorporate the Washburn School District into the schedule soon. Nelson is impressed by CCS and its value to the community around participants. Service Facilitators provide participants with a team of needed support and services. CCS Program Response to Committee Recommendations of Plan & Policy Updates Levno reviewed a letter to the committee accepting their Plan & Policy update recommendations from the January 2024 meeting. Motion by Notzke, second by Webb, to approve Bayfield Comprehensive Community Services Plan & Policy with the updates on addresses and phone numbers as needed. Motion passed. Motion by Kupczyk, second by Keelin, to approve the Regional CCS, January 09, 2024, meeting minutes as presented. Motion passed. Motion by Croteau, second by Notzke, to elect Thomas Mittlestaedt as Bayfield County Comprehensive Community Chairperson. Motion passed. Review Program Report Levno noted that the Ashland County referrals have been increasing. Ovaska stated this is not unusual after a holiday. Bayfield County referrals continue to steadily grow. Stanny questioned where CCS referrals come from. Ovaska noted that for Ashland County at least 50% of the referrals are made by the Tamarack Behavioral Health Unit. Levno noted referrals also come from Wellness and Recovery Courts, the Bad River Tribe, and through self-referrals. Croteau stated that just over 50% of referrals for Bayfield County come from other Bayfield County Department of Human Service units or programs including Aging and Disability, Economic Support, Youth Justice, Child Protective Services, Childrens Long-Term Services, and other Family Service programs. Croteau noted many referrals for Bayfield County also come from Tamarack Behavioral Health Unit. Croteau stated the number of children in the program continues to grow. There are currently fourteen youth in the program. Croteau noted providing services to children is more time-consuming and is more difficult during the school year. He reported that it is helpful to have additional vendor support to relieve some of the pressure off service facilitators to provide services after hours. Levno noted there are a few staffing changes. Levno is retiring on May 3, 2024. Ovaska was promoted internally to the position of the new CCS Administrator. Restructuring was necessary when Ashland County was unable to recruit needed licensed, Masters-level staff to fill Ovaska’s position of Service Director of ACCS and BCCS. Tom Croteau is taking over as BCCS Service Director. Job responsibilities of CCS Administrator and ACCS Service Director that do not need a licensed, Masters-level staff were combined to create the position of Quality Assurance and Improvement Coordinator – Ashland/Bayfield CCS. The person hired for this new position will be starting April 22nd, 2024. Bayfield is currently recruiting for a master’s level mental health professional. Levno reported CCS provider, Christian Servants Home Care, had been able to recruit and retain staff in a way that other contracted providers have not been able to dur to their unique business model. Levno noted that Visa Care continues to have trouble hiring staff. Levno reported she excited about Vista Care’s STAR Program. Using this model, Vista Care’s staff “have a minimum of a bachelor’s degree, are familiar with risk assessment and mitigation, and are supervised by fully licensed clinicians. Treatment includes trauma, interpersonal conflict, mood disorders, and grief/loss.” Levno reported the Ashland County Board has requested the Ashland County CCS team provide more outreach to the homeless. Ovaska noted staff have been present at Pearson Plaza the past few Thursdays trying to speak with homeless individuals who are present. Staff can help individuals place phone calls, provide local resources, and offer referrals to the CCS program when there is interest, and a referral is appropriate. The Brick is partnering with Ashland County to assist in providing outreach. CCS will report the impact of their outreach to the Ashland County Board at a future meeting. Children Services Ovaska provided a handout listing the services available to children in the CCS program. The handout provides an overview to parents, guardians, and participants new to the program. Kupczyk asked if local transportation needs were being met. Levno noted that for medical appointments CCS participants must use MTM (formerly Veyo). Ovaska noted that BART is a good local transportation resource. Croteau agreed BART is very accommodating. Levno and Croteau continue to conduct monthly discussions with the WI DHS and MTM so local issues with the non-emergency medical transportation provide by MTM are addressed. Stanny asked if there were still volunteer drivers to provide transportation. Croteau noted that Bayfield County has veteran volunteer services. Skulan stated that Aging and Disability also has a volunteer driver program for the elderly and disabled. However post-COVID, the pool is smaller. Levno noted that Ashland Aging and Disability has something similar. However, individuals who are eligible for transportation must use MTM when traveling to medical appointments. Discussion and Possible Action: New Business Levno asked the group about topics of interest for presentations at future meetings. Stanny requested a presentation regarding behavioral health inpatient availability and the impacts locally. Croteau noted it is a timely topic given the reduced inpatient availability with the renovations that are occurring at Tamarack Behavioral Health Unit. Croteau suggested Tom Jensen from Tamarack as a potential speaker on this topic. Levno noted that additional suggestions can be sent to Levno (through May 3, 2024), Ovaska, Croteau, or Service Facilitators. Kupczyk questioned if she or anyone else should act if they are aware of service providers who are out in public and they are not working (e.g., on their phones, etc.) when they should be providing services. Levno noted that she has personally reported this. Levno encouraged “if you see something, say something”. Levno also noted that CCS participants or their parents or guardians generally voice their concerns to staff members if a service or provider is not working when with the participant. Levno also noted that if there are multiple complaints, CCS will discontinue authorizing services with the provider. Croteau recognized Levno for her many years of service to the county, committee, and region. Levno thanked the group for their dedication to the committee. Mittelstaedt also thanked Webb for her service on the committee. Opportunity for Public Comment Bigboy stated she appreciated being able to join the meeting today. Informational Items (other) Mittelstaedt thanked the staff for making meetings available virtually as well as in person. Future Meeting Dates July 9, 2024 – Ashland County 12:30 p.m. October 8, 2024 – Bayfield County 12:30 p.m. The meeting was adjourned at 1:28 p.m. Respectfully submitted, Sarah Traaholt, Bayfield County Clerk (715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org TO: Bayfield County CCS Coordination Committee FROM: Val Levno DATE: April 12, 2024 Thank you for your recommendations after reviewing the Bayfield County Comprehensive Community Services (BCCS) plan and policies updates. We accept your recommendations as made during the April 9, 2024 Bayfield CCS Coordination Committee meeting. The changes include:  Deleting CCS Service Director as a CCS Shared Service and removing language specific to Service Director being shared.  Updating Program Staff Roster  Updating administrator who is member-at-large on Regional Coordination Committee Roster Sincerely, Valerie Levno, MSEd, LPC ACCS Administrator Department of Human Services 117 East Fifth Street P.O. Box 100 Washburn, WI 54891-0100 Telephone (715) 373-6144 Fax (715) 373-6130 Email: baycodhs@bayfieldcounty.org Inpatient BH Care – admission through the emergency department  Behavioral Health Admission o Acute or recurrent behavioral health condition o Danger to self or others o Acute symptoms related to their psychiatric condition o Involuntary (Chapter 51) o Danger medical condition will worsen without psychiatric admission  Detoxification Admission o Functionally impaired o Unable to detox in alternative setting o Incapacitation due to substances  Incapacitation hold can only be initiated upon admission to BHU and ED cannot institute a hold  Admission process o All BH patients must be medically evaluated prior to admission to BHU o Restriction regarding admissions:  Physical illnesses are more acute than behavioral health conditions  Active medical condition that risks contamination of the entire unit and cannot be effectively managed in the BH setting  Forensic admissions or sustained law enforcement presence  Known history of aggressive or dangerous behaviors that would compromise the safety/welfare/treatment of other patients and staff  Primary diagnosis of mental retardation or developmental disability Outpatient Care – call 715-685-5400 for services  Therapy for children and adults  Medication/psychiatry services for children and adults  Intensive Day Program for adult individuals with mental illness  Psych testing for children and adults  Recovery Services individual counseling for adolescents and adults  Intensive Day Program for adults starting in Recovery Services  Recovery Peer Support covering all requests throughout the organization  Adult sensory modulation with our occupational therapy staff (715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org BAYFIELD COUNTY COMPREHENSIVE COMMUNITY SERVICES 2023 QUALITY ASSURANCE REPORT Program Description The Bayfield County CCS program provides individualized treatment in the home and community for persons of all ages who need ongoing services for a mental illness, substance use disorder, or a dual diagnosis beyond occasional outpatient care, but less than the intensive care provided in a Community Support Program or an inpatient setting. There is a focus on person centered planning and providing the rehabilitative treatment individuals need to live their best lives. The participant works with a dedicated team of service providers to develop a service plan to meet the individual's unique needs and goals. The goal of this community-based approach is to promote better overall health and life satisfaction for the individual. The office is located at 117 E 5th Ave in Washburn, Wisconsin. Fifty-nine (59) participants were served in 2023. Fourteen (14) participants were children. There were seventeen admissions and thirteen (13) discharges in 2023. Staff includes a part-time Administrator, part-time Service Director, full-time CCSS Supervisor/Mental Health Professional/Substance Use Professional/Psychotherapist and three full- time Service Facilitators. In addition, the program was supported a Master’s level intern and two part-time Behavioral Health Case Managers. The Administrator and Service Director are shared staff with the Ashland Comprehensive Community Services program. Participants were served by twenty-two (22) Service Array Providers including peer specialists, parent peer specialists, equine assisted learning specialists and in-home/community skill building specialists. We contracted with twenty-six (26) people to provide psychotherapy, and three of which can also provide substance use assessments (ASAM) and four people to provide adult mental health day treatment. The individuals served by the program in 2023 have been given the diagnosis of the following substance use and mental illness disorders. This graph indicates mood disorders are a primary Bayfield CCS diagnosis. 81% of Bayfield CCS participants had more than one diagnosis. 0 10 20 30 40 50 60 Thought Disorders Mood Disorders Substance Use Diagnoses Other Diagnoses Number of Diagnoses by Category Department of Human Services 117 East Fifth Street P.O. Box 100 Washburn, WI 54891-0100 Telephone (715) 373-6144 Fax (715) 373-6130 Email: baycodhs@bayfieldcounty.org REPORT ON 2023 PROGRAM GOALS 1. Increase contracted providers of home and community services by 5%. This goal was met. See below. o Ask current contracted agencies of home and community services to expand their work force at minimum 5%. This will be evident by CCS County Oversight reports. Compare number of CCS providers at the end of 2022 with the number of CCS providers at the end of 2023.  There was a significant increase in the number of CCS providers in 2023, by over 20%. The increased providers included psychotherapists, health and life coach, yoga/CrossFit instructor, certified peer specialist and home/community skill building providers. o Attract agencies providing CCS services in other counties to expand to Ashland CCS and Bayfield CCS. This will be evident by CCS County Oversight reports. Compare number of CCS vendors at the end of 2022 with the number of CCS vendors at the end of 2023.  The large increase in CCS providers noted above was due to the large increase in CCS vendors. o Encourage current vendors to attend local opportunities to increase the work force. CCS administrator or designee to attend if appropriate.  Vendors were encouraged to attend two Northland College Job Fairs and a University of Wisconsin Superior Job Fair. 2. Increase MHSIP Adult mean domain score of “I feel I belong in my community” to 3.5 mean score in Ashland CCS and 3.6 mean score in Bayfield CCS. This will be evident by increasing contracted providers as indicated above to allow additional skill building opportunities that are community based and Service Facilitators will identify resilience in CCS participants and expand on it.  The Bayfield MHSIP Adult mean domain score of “I feel I belong in my community” in 2023 is 3.7. This goal was met. 3. Increase MHSIP Adult mean domain score of “I do better in social situations” to 3.5 mean score in Ashland CCS and 3.9 mean score in Bayfield CCS. This will be evident by increasing contracted provider of home and community services as indicated above to allow additional skill building opportunities. Service Facilitators and CCS contracted providers to support CCS participants to increase potential areas of social connection and ways to increase social connection. Increased contracted provider of home and community services as indicated above to allow additional skill building opportunities. Psychotherapy will continue to focus on family relationships when appropriate.  The Bayfield MHSIP Adult mean domain score of “I do better in social situations” is 4.1. This goal was met. DISCUSSION OF PROGRAM OUTCOMES TARGETED IN THE CCS OUTCOME EVALUATION PLAN I. THE TREATMENT/ REHABILITATION PROCESS WILL BE PARTICIPANT AND/OR GUARDIAN DIRECTED AND CONSIST OF A PARTICIPANT/GUARDIAN/ STAFF PARTNERSHIP Rationale: Mental Health Participant and Guardian activists in the national “Recovery” movement point out that recovery only occurs when Participants believe they can get better and work in partnership with mental health treatment providers to make it happen. They measure Participant and/or Guardian satisfaction by the extent to which there is genuine Participant, Guardian and staff collaboration in the planning and implementation of the treatment process. CCS makes an effort to establish partnerships with CCS Participant and/or Guardians in the following ways:  People receive factual information about their illness. This helps people strip away some of the mythology and stigmatizing baggage connected with a mental illness diagnosis. It also offers people hope that they can make a good life for themselves despite their illness. It provides them with tools to begin to identify and track their symptoms, take ownership over their daily health routine, and design their own plans for any psychiatric crisis intervention.  Share available treatment options. CCS aims to assist people to select and individualize the array of supports they need to experience stable health, achieve education and employment goals, enjoy good relationships with friends and family, and experience greater personal fulfillment.  Work jointly to develop a Recovery Team and Service Plan. Recovery planning is a several stage process. It begins with the Service Facilitator formally or informally meeting with a CCS Participant and/or Guardian and identifying what steps can be taken in the next six months toward meeting the Participants goal for their life and who they would like to support them. Participant and/or Guardians are invited to involve their family members or other allies in this process. To measure Participant and Guardian participation and ownership of their mental health treatment Bayfield County CCS program utilizes these indicators: Participant and/or Guardian participation in formulation of the Service Plan (Target: 100%) Service Facilitators actively engage CCS Participant and/or Guardians in the formulation of their Service Plan. Service Facilitators report that fifty-five (55) out of fifty-nine (59) total individuals participated in the formulation of Service Plans. Of the four (4) participants and/or Guardians who did not participate in the formulation of service plans, below are the reported reasons for their lack of participation.  Two (2) were due to non-engagement in the first 30 days  One (1) due to change in placement and new guardian supported not being in the program.  One (1) participant’s symptoms increased and was transitioned to inpatient status. Service Plans read and signed by Participant and/or Guardians. (Target: 100%) Two Participants were discharged before the Service Plan was due. 98% (54 of 55 participants or guardians) who participated in the formulation of the Service Plans signed the Service Plans. Informed Consents for Treatment (Target: 100%) Upon admission to CCS, all Participant and/or Guardians are required to sign a CCS Admission Agreement and Informed Consent for Treatment, HIPPA Participant Privacy Rights Policy and given both a written and verbal explanation of Wisconsin’s Client Rights. As part of their annual service planning process, all CCS Participant and Guardians are also asked to sign an updated Informed Consent for Treatment and receive another explanation of their Client Rights. One hundred percent (fifty-nine) of CCS Participants and/or Guardians signed the informed consents for treatment. II. PARTICIPANTS WILL RECEIVE APPROPRIATE PSYCHIATRIC CARE Rationale: Early treatment increases the chance of a successful recovery. We measure the number of Participants receiving inpatient psychiatric or substance abuse care over time: Percentage of people requiring inpatient psychiatric hospitalization, substance abuse inpatient hospitalization, residential treatment (15% or less of people in program longer than 12 months. 35% or less of people in program 1-12 months.) 17% of enrolled BCCS Participants (Ten (10) of fifty-nine (59) total) were hospitalized for inpatient psychiatric, substance abuse or residential treatment in 2023. Two (2) of those individuals (20% of all requiring inpatient or residential treatment) were in the CCS program less than 12 months when they utilized that treatment, and 80% (8 individuals) had been in the program for more than 12 months when they utilized treatment. III. QUALITY OF LIFE - PARTICIPANT/GUARDIAN PERSPECTIVE Completion of a Mental Health Statistical Improvement Program (MHSIP – Adult, Family and Youth Scales) satisfaction surveys. (Target: 50% return rate from Participants and/or families and a 51% satisfaction rate) The satisfaction surveys were given to eligible Participant or Guardians (for participants who received services for at least the past six months) during the months of October and November 2023 with a letter of explanation and an envelope to return the completed survey confidentially to the CCS Administrator. For each survey completed, the Participant or Guardian was given a 83% 14%3% INPATIENT AND RESIDENTIAL TREATMENT ENGAGEMENT OF CCS PARTICIPANTS Enrolled participants who were not hospitalized or transitioned to residential treatment in 2023 Participants who were in the CCS program more than 12 months when hospitalized or transitioned to residential treatment Participants who were in the CCS program less than 12 months when hospitalized or transitioned to residential treatment $5 gift card to Wal-Mart or Hansen’s IGA. The surveys were hand delivered by Service Facilitators and Service Facilitators gave several verbal reminders to CCS Participants or Guardians who had not completed a survey timely. Twenty-three (23) MHSIP – Adult Scale surveys were returned of twenty-nine (29) surveys given to eligible Participant or Guardians (79% return rate). Five MHSIP – Youth surveys were completed / returned, and one of two family surveys were completed. Because of the confidential nature of the survey, we did not use the returned family survey. The overall mean for the BCCS MHSIP – Adult Scale was 96% general satisfaction in 2023, compared to the general satisfaction mean score of the State (92%). The overall mean for the BCCS MHSIP – Youth Scale was 90% general satisfaction in 2023; a slight decrease from the 92% general satisfaction score in 2022, but still higher in comparison to the State’s mean general satisfaction score in 2023, of 86%. 4 3.9 4 4.4 4.4 4.4 4.5 4.1 4 4.2 4.6 4.6 4.6 4.8 4 3.9 4 4.6 4.6 4.6 4.6 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Perception of Functioning Perception of Social Connectedness Perception of Outcomes of Services Perception of Participation in Treatment Planning Perception of Quality and Appropriateness Perception of Access General Satisfaction Mean Score Adult Satisfaction Survey Scores Over Time -BCCS 2022 BCCS Mean Score 2023 BCCS Mean Score 2023 State Mean Score CCS Participants and Guardians are empowered to actively participate on the Coordination Committee. No less than one-third of the membership of the Coordination Committee is CCS Participants or Guardians. The Bayfield CCS Coordination Committee make-up in 2023 included the following, for a total membership of seven individuals. 57% of the membership is CCS participants:  Four (4) CCS participants  One Tribal nation employee  One mental health or substance use service provider  One interested citizen 3.9 4.5 4.3 3.8 4.3 4.4 4.3 4.2 4.7 4.6 4.2 4.4 4.7 4.5 4.7 5 4.7 4.5 4.5 4.5 4.6 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Perception of Functioning Perception of Social Connectedness Perception of Outcomes of Services Perception of Participation in Treatment Planning Perception of Quality and Appropriateness Perception of Access General Satisfaction Mean Score Youth Satisfaction Survey Scores Over Time -BCCS 2022 BCCS Mean Score 2023 BCCS Mean Score 2023 State Mean Score COMPREHENSIVE COMMUNITY SERVICES PLAN ASHLAND COUNTY AND BAYFIELD COUNTY REGION OUTCOME EVALUATION PLAN 2024 Aspect of Programming or Treatment Indicators Measures of Success Data Source Frequency of Assessment CONSUMER/STAFF PARTNERSHIP IN THE RECOVERY PROCESS Participant participation in their own treatment and rehabilitation process 1. Participation in formulation of the Service Plan 2. Informed Consents for Treatment 1. 100% of consumers will have progress notes showing specific discussion of their Service Plan. 2. 100% of the time 1. Service Plan signature page 2. Review of charts and documentation 1. 2x/yr. by Service Directors/Mental Health Professionals 2. 2x/yr. by Service Directors/Mental Health Professionals HEALTH, WELLNESS AND SAFETY Indicators Measures of Success Data Source Frequency of Assessment Program focus will be to work with participants to increase completion of safety plans and ongoing continued discussion at reviews around updating/completing of safety plans. 1. Percentage of people presented with an opportunity to complete a safety plan as well as having increased safety plans on file for participants 2. Service Facilitators will offer an update to or the option to complete one if they did not previously. 1. 100% of CCS participants will be offered the option to complete a safety plan and have one on file with the CSP programs. Signatures will be obtained from participants either on a completed safety plan or blank plan noted that they did not want to complete one at this time. 2. 100% of participants will be asked to update or complete a safety plan on review months if they previously declined. 1. CCS clinical chart documentation 2. Intake, semi-annual and annual reviews 1. 2x/yr. by Service Directors/Mental Health Professionals 2. 2x/yr. by Service Directors/Mental Health Professionals COMPREHENSIVE COMMUNITY SERVICES PLAN ASHLAND COUNTY AND BAYFIELD COUNTY REGION OUTCOME EVALUATION PLAN 2024 PROGRAM HONORS THE CSP PARTICIPANT PERSPECTIVE Indicators Measures of Success Data Source Frequency of Assessment Quality of Life – Consumer Perspective Consumer language, race and ethnicity is collected to provide the best individualized care and non-discriminatory support to participants within the community. 1. Completion of State Satisfaction Survey on semi-annual review or annually 2. CCS participants are empowered to actively participate on the Coordination Committee. 1. Collecting language, race, and ethnicity 1. Return rate of 50% from participants. The majority of scores given on the questionnaire fall in the satisfied arena. 2. No less than one-third of the membership of the Coordination Committee is CCS participants. 1. 100% of participant information will be collected 1. Responses received will be entered into the Wisconsin eInsight website. 2. ACCS Coordination Committee Roster and BCCS Coordination Committee Roster. 1. Echo profile page/QA Form 1. 1x/yr. by Administrator/Quality Assurance and Improvement Coordinator 2. 1x/yr. by Administrator/Quality Assurance and Improvement Coordinator 1. 2x/yr. by Service Directors/Mental Health Professionals Ashland/Bayfield County Comprehensive Community Support Coordination Committee Program Report July 2024 Enrollment Information: Provider Network: - Christian Servants Home Care – advertising for another part-time skill building position - VistaCare WI –still looking for another skill building position - Nature-related skill building - Rocky Hill- hiring another peer support specialist, Kevin Dahlke came on board and has started to provide services and supports - Indigo- looking to hire another peer support specialist and hiring for position as supervisor Best Practice: - Nothing at this time Ashland February March April 2024 1st Quarter May Total 33 35 34 47 30 # of Children 2 1 2 3 2 Intakes 1 2 4 10 5 Discharges 3 4 4 12 6 Referrals Received 5 7 4 13 3 Referrals Closed 0 3 0 1 7 Referrals Pending @ end of month 7 3 8 8 4 Ashland 2024 2023 2022 Total 51 80 94 # of Children 4 7 7 Intakes 16 37 49 Discharges 21 44 53 Referrals Closed 21 49 54 Referrals Pending 1 1 14 Referrals Received 22 67 108 Bayfield February March April 2024 1st Quarter May Total 47 49 48 51 49 # of Children 13 13 14 12 14 Intakes 1 2 0 3 2 Discharges 0 1 0 4 1 Referrals Received 2 2 2 6 2 Referrals Closed 2 1 1 3 3 Referrals Pending @ end of month 4 3 6 14 7 Bayfield 2024 2023 2022 Total 52 59 65 # of Children 14 14 12 Intakes 6 17 34 Discharges 3 13 23 Referrals Closed 13 20 26 Referrals Pending 7 6 2 Referrals Received 14 34 41 Staffing: - BCCS hiring Mental Health Professional/Service Facilitator. - Brittny White gave notice for her SF position in ACCS Marketing and Outreach: o Upcoming –  Ashland Birth Center  Tamarack Health – 50th annual Community Recovery Picnic – early September  Awaiting specifics about Non-Profit Fair in August o Completed So Far –  Wisconsin Family Ties 6/27/24  Northern Great Lakes Visitor Center / Wildlife Refuge meeting 6/26/24  Planet Youth Community Conversation Meeting 6/6/24  Chequamegon Bay Overdose Awareness Event Meeting 6/5/24  Chequamegon Bay Area Non-Profit Summit 5/30/24  Essentia Health Workforce Development meeting 5/29/24  VRNA / DVR meeting 5/28/24  Ashland County Children’s & Adult Units 5/23  SPARK 5/23  The BRICK 5/21  DOC / Probation & Parole 5/17  Ashland School & Community Event 5/11 Areas of Improvement: - Continuing to work on Echo and further outreach and updating the brochure and flyer to more participant friendly terms and QR codes Are a Bayfield or Ashland County resident Are enrolled in Wisconsin Medicaid or BadgerCare Plus Have a mental health or substance usediagnosis made by a medical doctor Experience impairments that interfere with major life activities or goals Final eligibility will be determined uponintake, using a State Mental Health /Alcohol and Other Drug Abuse FunctionalScreen You Are Not Alone Your Journey to Mental Health or Substance Use Recovery Begins Here CCS is available to children and adults who meet the following criteria: WHO IS ELIGIBLE? Ashland County Comprehensive Community Service (CCS) Program 630 Sanborn Ave Ashland, WI 54806 Scan the QR code boxes with your cell phone camera for more information on our websites or to start a virtual referral Bayfield County Comprehensive Community Service (CCS) Program 117 East 5th St. Washburn, WI 54891 Phone: 715-682-7004 | Fax: 715-682-7924 ccsintake@ashlandcountywi.gov COMPREHENSIVE COMMUNITY SERVICE PROGRAM (CCS) Refer yourself or someone you care about today! Scan this QR code with your phone to complete a virtual referral, call or email 715-682-7004 | ccsintake@ashlandcountywi.gov www.bayfieldcounty.wi.gov/1285/Comprehensive-Community-Services wwww.ashlandcountywi.gov/ health_human_services https://forms.gle/ 9cEj4aQVLWMWfAJL7 https://forms.gle/ 9cEj4aQVLWMWfAJL7 A recovery-focused support program that provides mental health and substance use services to people of all ages. Participants work with a Service Facilitator and Recovery Team, to direct services needed to make progress toward goals they set. CCS is voluntary - participants must choose to be in the program CCS is recovery-focused and respects the participant’s needs CCS Provides coordinated behavioral health and psychosocial rehabilitation services Assists individuals use of professional, community and natural supports to achieve their personal goals Creates an individualized recovery plan - a unique combination of the participant’s direction and professional input Is a community-based program where most services are provided in the participant’s home and local community WHAT IS CCS? Refer yourself or someone you care about today! Scan the QR code for an online referral form 715-682-7004 ccsintake@ashlandcountywi.gov Individual Therapy Substance Use Counseling Equine Therapy Peer Specialist Support Supportive Family Education Effective Medication Use Support Crisis Prevention & Management Physical Health and Monitoring Individual Skill Development for: finding housing, employment, budgeting, daily living skills like grocery shopping, completing paperwork, home and appointment organization, community engagement, healthy coping skills (Yoga, Cross Fit, Crafts, etc.) Each person’s service plan and supports look different, because needs and goals are unique to that individual OUR SERVICES An important part of CCS is the creation of an individualized Recovery Team. It includes the participant, a Service Facilitator, Mental Health Professional, other professionals such as therapists, doctors, skill development providers, and any other individuals such as family or friends that the participant wishes to include on their team for advocacy and support. Support the participant living successfully in the community by addressing barriers to access housing, transportation, employment, health, social, recreational, educational and spiritual resources CCS VISION Reduce negative behavioral health impacts and restore participants to the best possible level of functioning and independence Provide participant-directed, flexible wraparound services Participants take control of their lives and are aided in developing skills and resources to make this a reality CCS strives to be culturally relevant and respectful of a participant’s unique needs and values Services provided under CCS areindividually determined through the assessment andservice planning process. Supports based on clinicial need may include: https://forms.gle/9cEj4aQVLWMWfAJL7 Scan the QR code to refer yourself or someone you know ccsintake@ashlandcountywi.gov 715-682-7004 DO YOU NEED HELP TO ACHIEVE YOUR RECOVERY GOALS? Final eligibility will be determined through a functional screen at intake Open to youth / adult residents of Ashland and Bayfield Counties Must be enrolled in Wisconsin Medicaid or BadgerCare Plus Have a mental health or substance use diagnosis made by a medical doctor Experience impairments that interfere or limit major life goals Examples include: Individual therapy Substance Use Counseling Equine Therapy Peer Specialist Support Supportive Family Education Effective Medication Use Support Side-by-side Skill Development for: finding housing, employment, budgeting, grocery shopping, completing paperwork, home and appointment organization, community engagement, healthy coping skills (Yoga, Cross Fit, Crafts) Wrap-around supports are based on clinical needs Comprehensive Community Services (CCS) is a recovery-focused support program that provides mental health and substance use services to people of all ages. https://forms.gle/9cEj4aQVLWMWfAJL7